MEDICARE: DR. ROBERT I GUDA OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC2805FL	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780696021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT I GUDA OD

Provider Business Mailing Address
First Line	:	6376 PINE RIDGE RD UNIT 170
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3927
Country	:	US
Telephone Number	:	239-384-9905
Fax Number	:	239-384-6975

Provider Business Practice Location Address
First Line	:	6376 PINE RIDGE RD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3908
Country	:	US
Telephone Number	:	239-384-9905
Fax Number	:	239-348-6975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	06/17/2024

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